Use with Caution, or Not At All
My Short History of Diet Soda Consumption
I have had several conversations recently on the topic of diet soda and artificial sweeteners and their impact on our health. This post is in response to those conversations. I should start by prefacing that I used to be a soda drinker, I admit it. In high school, it was part of my lunch and my breakfast. When I would get to school my first stop was the bookstore for a Bavarian cream filled, chocolate frosted donut and a 20oz Dr. Pepper. Looking back, it’s shocking what I ate times. Lunch was similar; fast food and a fountain—drink, often my poison of choice was another DP or Mountain Dew. I was never into the diet soda. It tasted off, funny, and gross to me. As I got older and into my twenties, college, work, life etc… I made the switch to diet coke with the belief that it was better for me, healthier, and would help slow or stop my weight gain. I was wrong on all accounts. I continued to balloon and my health continued to decrease little by little. At the peak, my Diet Coke consumption was a 44oz Diet Coke to start the day, which got me through my commute and to lunch; lunch included a refill, and that would generally get me to home; and at home, two liters were waiting in the fridge for a glass or two during the evening. On game day, Sunday, watching football I would be stocked up, and I would easily consume at least one two-liter while watching football. Sometimes more. I don’t recall drinking water much, it had no flavor or taste, but diet coke was “amazing.” Fast forward to 2018, I have rarely touched any soda in eight years. I don’t like it anymore, and I learned a lot along the way about how it affects the body.
Diet Soda’s Impact on Health
For 10 years, researchers followed diet-soda drinkers and non-diet-soda drinkers, their study showed that diet soda drinkers waist sizes grew 70% percent more than non-diet-soda drinkers, and that those who consumed at least two or more diet sodas per day had a 500% greater increase in waist size1. In 2015, they published their study of a dose-response relationship between consumption of diet soda and waist circumference1. This is not to say that drinking regular soda full of high fructose corn syrup or cane sugar is healthy or does not lead to an increase in weight gain, it does, these impacts were observed as well; however, the point is that diet soda containing artificial sweeteners, such as aspartame and sucralose, had an increase in waist size and weight gain that surpassed those who consume sugary soda drinks. Why does waistline size matter? Your waistline has a strong correlation to fat accumulation—particularly visceral fat, which is stored around the waistline. Visceral fat has been well documented to be a contributing factor to metabolic syndrome, type II diabetes, heart disease, and other negative health factors2,3.
Another way we are impacted by artificial sweeteners occurs in the brain by tampering with our food cravings and creates a negative cycle. A cycle that can be difficult for us to get out of. Artificial sweeteners are actually sweeter than real sugar. They have also been found to have addictive properties. They first alter our taste, so we prefer the artificial sweetener over real food, like fruits and vegetables, they even alter our perception and taste of real sugars. The sweeter foods can be more addictive than cocaine12,13 and artificial sweeteners are the sweetest. Let’s review real quick, artificial sweeteners found in diet sodas and other processed foods have been found to increase our waist sizes—which leaves us prone to a host of health problems, and they can be addictive which means we will want more of them.
Studies have found that artificial sweeteners, while containing no calories for energy, still elicit a metabolic response 5,6,7. This can lead to mixed signals in the body which, in turn, leads to increased cravings and more hunger. Follow this path to its logical conclusion and we see an overconsumption of processed, high carbohydrate foods to satisfy the cravings these artificial sweeteners have induced.
Our bodies are complex, calories in versus calories out is a bit too simplistic. It overlooks look hormonal responses that food and environment have on our bodies. Diet sodas and processed foods that use artificial sweeteners are no exception. While as artificial sweeteners are often touted to be inert and have no effect on the body, the evidence is mounting that artificial sweeteners do have an effect, even if we do not fully understand all of the mechanisms just yet. While animal studies have shown insulin and glycemic responses to the consumption of artificial sweeteners, few human trials have replicated this finding and it not clear why just yet. One study did find a connection between insulin and blood glucose levels in a human trial using oral glucose tests that contained an artificial sweetener.4. This indicates to me that it’s a mixed bag of results at this time and more research is needed. We do know, that artificial sweeteners are addictive and have effects on our brain health as well 5,8. Artificial sweeteners have been linked to headaches, behavioral and cognitive problems, mood swings, anxiety and can impact our memory5,8,9. They signal dopamine response in the brain and they lead to increased cravings. Studies have also demonstrated that artificial sweeteners have a negative impact on our micro biome5,7. It alters the environment that also leads to an increase in appetite and cravings for sugary, high carbohydrate foods, as well as, influences hormones in the gut that aid in regulating insulin5,7.
Artificial sweeteners alter our cravings and the reward centers in the brain and gut that results in cravings for more sugary foods and simple carbohydrates5,7. With over-consumption, these sugary foods do have an impact on our blood sugar and insulin sensitivity over time which leads to chronic illness. We also are now seeing studies show that chronic consumption of artificial sweeteners can also impact our glucose sensitivity over time.6,10
Conclusion
The health risks far outweigh the rewards when consuming artificial sweeteners in our food and drinks, and diet sodas should be eliminated from a healthy lifestyle. Artificial sweeteners have been linked to obesity and an increased risk of heart disease, type II diabetes, stroke, obesity, dementia, anxiety, headache, and cancer2.
The image to the right is what we are sold by advertisers and food manufacturers. “look
good, skinny and enjoy the sweetness of a calorie-free food.” The image is far from the truth. Some may stay thin, more will add to their waistline, and most of us, visible or not, will have adverse health effects in our microbiome, which is a vital and complex system in our body.
While many people opt for low calorie and zero calorie foods, snacks, and beverages under the impression they are improving their health by reducing their calorie intake and fat intake, they are making matters worse by consuming food like products and drinks. There is a common belief that if it is in our food system it must be safe for consumption. To fully explore that statement is another lengthy article on its own, and one we hope to take on in future. The main take away is this: Food-like products are just that, food-like, they are not real food. Most artificial sweeteners on the market are fully synthetic, and even the much-touted Splenda, a “healthier alternative” to aspartame products, has many similar negative health effects when consumed. The best approach to health and wellness is one that revolves around real food, whole food, in conjunction with a healthy lifestyle — not one full of quick shortcuts that in the long run short change us.
By Nathan Marsala

References:
1 – Diet Soda Intake Is Associated with Long‐Term Increases in Waist Circumference in a Biethnic Cohort of Older Adults: The San Antonio Longitudinal Study of Aging Sharon P.G. Fowler MPH Ken Williams MS Helen P. Hazuda PhD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498394/
2 – Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Fox CS1, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, Vasan RS, Murabito JM, Meigs JB, Cupples LA, D’Agostino RB Sr, O’Donnell CJ. https://www.ncbi.nlm.nih.gov/pubmed/17576866
3 – Metabolic obesity: the paradox between visceral and subcutaneous fat. Hamdy O1, Porramatikul S, Al-Ozairi E. https://www.ncbi.nlm.nih.gov/pubmed/18220642
5 – https://usrtk.org/sweeteners/aspartame_health_risks/
6 – https://www.cell.com/current-biology/fulltext/S0960-9822(17)30876-X
4– Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load M. Yanina Pepino PHD, Courtney D. Tiemann, MPH, MS, RD, Bruce W. Patterson, PHD, Burton M. Wice PHD and Samuel Klein MD Diabetes Care 2013 Apr; DC_122221. https://doi.org/10.2337/dc12-2221 Curr Biol. 2017 Aug 21;27(16):2476-2485.e6. doi: 10.1016/j.cub.2017.07.018. Epub 2017 Aug 10.
7- Metabolic Effects of Non Nutritive Sweeteners M. Yanina Pepino, PhD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661066/
8- Neurophysiological symptoms and aspartame: What is the connection? Choudhary AK1, Lee YY1. https://www.ncbi.nlm.nih.gov/pubmed/28198207
9- Aspartame and the hippocampus: Revealing a bi-directional, dose/time-dependent behavioural and morphological shift in mice. Onaolapo AY1, Onaolapo OJ2, Nwoha PU3. https://www.ncbi.nlm.nih.gov/pubmed/28049023
10- Aspartame intake is associated with greater glucose intolerance in individuals with obesity. Kuk JL1,1, Brown RE1,1. https://www.ncbi.nlm.nih.gov/pubmed/27216413
11- https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030